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Sports Medicine/Joint Pain and cortisol injection


about 1.5 years ago I organised an armwrestling competition.During the training I tried a technique I found on google on how to lock a shoulder and sadly when I armwrestling a very big guy he injured my shoulder.My shoulder was kind of bent during the armwrestle.The injury was not bad but I had an armwrestling tournament in two weeks and a tug of war in a month which I did not want to loose.I decided to continue bodybuilding training and take antiinflammatories to dont feel the pain and possible treat the injury.After a month of taking the drugsd and the competition was gone I could barely lift my arm and I had a joint pain (kind of pain in my bone) at the front.I rested it as much as I could however when I swam or lifted something or try a push up I used to feel lot of pain in my bone.There seems to also be a loose in my bone.I had bought an alpha stim which gave me the movement bck but pain never gone completely.I saw a doctor which made me an ultrasound and he could see that in the V joint of my shoulder in the injured one there was inflammation and distance of 9cm whereas in the other one a distance of 4 cm.Hesaid that a cortisol injection would benefit me and he gave me one.He said that he would rest it two months even if pain goes to leaver it healing.I rested it for like a month and since then I swam everday and no pain.I never forced myself to the max but the pain which was very near is at least very distance now.A second doctor had told me to dont go heavy before 6 months from injury as pain sometimes comes back so I   did not train,however now am getting very nervous.I dont know what to think as I dont want the pain to come as when I had the cataflam but most probably I am overworrying.I dont want to take more injections as I want to know where I stand.I dont know what to think but I read and heard that for some people the injection does not last long so I guess I 4 months no pain and I been swimming in quite good.I follow your advice.Thanks.

Hello David!

With a good description of the shoulder pain, I will try to piece this together to give you an oversight of what I believe to be the specific injury.  Firstly, I have no idea your age, but am guessing it must be between 16 and 25? If it is under 16, this could be a serious consequence, but then again, if you are over 25, it's not an easy task to heal.  Don't get excited though, we will try to put this together.

As a medical diagnosis, did your Doctor ever take an Xray or MRI of the shoulder?  You didn't mention it, so I assume you did not have this done. An Ultrasound is not as definitive as the other two diagnostic modalities. Your initial injury seems to have torn the Rotator Cuff.........a thick tendon that surrounds the you said it was "bent" after the Big Guy probably "locked" the shoulder backwards, thereby tearing the Rotator Cuff. Without proper treatment, the shoulder will lose its' strength, and as happened with you, the "bone" was painful. Taking anti-inflammatories will not fix anything but cloud the brain where the pain centers lay. In the meantime, the small bursae (within all joints in the body), in the shoulder have collapsed, and are torn up...for lack of a better explanation.  This alone causes considerable pain with almost any motion, or weight-bearing, of the arm. Additionally, you might have had a partial dislocation of the shoulder, which in turn, would have precipitated the other problems you describe.

When doctors run out of excuses for your pain, they will sometimes use cortical steroids to "heal" the injuries.  There is a time and place for steroid injections, but orthopedic injuries is not a good idea.  Steroid injections will develop scar tissue which is a tough grizzle with no expansion properties, no blood supply, and no sympathy for non-healing tissues. I will not dwell on a training schedule for you, as training is out of the question
for now.

In conclusion, you and your doctor have reached an abyss, and it is time for the big guns to come on board.  You need to find out who is the very best shoulder Orthopedic Surgeon, and get a consultation appointment. You have a classical surgical component that needs to be fixed very soon, if not earlier. You have done a good job of self-healing, but it is time to get very serious about fixing the shoulder, especially after 18+ months of further injuring it with training and weighted exercises.  Please get a referral from your coaches, friends, and acquaintenances as to who is the best Orthopedic Doctor.  Make an appointment for as soon as you can get in to see him.  No more injections, anti-inflammatories, training, etc., for that arm/shoulder until you get the real story from your new physician. Good luck to you, David, and it will take some patience on your part to follow the orders of the Orthopedic Surgeon so you can heal it without residual problems as you get older.  

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Dr. Patricia B. Arthur, DC, MRC, CST


As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.


Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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